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This is VAERS ID 266568

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

266568
VAERS Form:
Age:12.0
Gender:Female
Location:West Virginia
Vaccinated:2006-10-25
Onset:2006-10-25
Submitted:2006-11-01
Entered:2006-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0955F / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Irritability, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Fussy body rash X 24 hours following vaccination. Cleared spontaneously.


Changed on 12/8/2009

266568 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:West Virginia
Vaccinated:2006-10-25
Onset:2006-10-25
Submitted:2006-11-01
Entered:2006-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. 0955F / 1 LA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Irritability, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Fussy body rash X 24 hours following vaccination. Cleared spontaneously.


Changed on 9/14/2017

266568 Before After
VAERS Form:(blank) 1
Age:12.0
Gender:Female
Location:West Virginia
Vaccinated:2006-10-25
Onset:2006-10-25
Submitted:2006-11-01
Entered:2006-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 1 2 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Irritability, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Fussy body rash X 24 hours following vaccination. Cleared spontaneously.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=266568&WAYBACKHISTORY=ON


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